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Individual

DARREN C JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3741 W 12600 S, RIVERTON HOSPITAL, RIVERTON, UT 84065
(801) 285-4000
(801) 733-5618
Mailing address
3340 NORTH CENTER ST #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
376223-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100501911
NV
01
107008929102
IHC
UT
05
118953100
WY
01
1502954
UMWA
UT
05
165193
AZ
01
2090168
UNITED HEALTHCARE
UT
01
37622312001001
BCBS
UT
01
657904
DESERET MUTUAL
UT
01
73604
PEHP
UT
05
806755000
ID
01
870545614DJ3
EDUCATORS MUTUAL
UT
01
94410
HEALTHY U
UT
01
QM0000075886
ALTIUS
UT
01
TPRA09321
MOLINA
UT
Enumeration date
09/06/2006
Last updated
10/15/2012
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